CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S15-S16
DOI: 10.1055/s-0041-1730686
Abstract

Pharmacomechanical Thrombolysis with Liberal Use of Stenting Reduced Postthrombotic Syndrome in Iliofemoral Deep Vein Thrombosis: Single-Center Experience

Owayed Al Shammeri
Habib Medical Group, Riyadh, Saudi Arabia
,
Ola Katheri
Habib Medical Group, Riyadh, Saudi Arabia
,
Ahmad Al Ali
Habib Medical Group, Riyadh, Saudi Arabia
› Author Affiliations

Background: Postthrombotic syndrome is common after deep vein thrombosis despite anticoagulant therapy. The symptoms range between leg heaviness and itching to venous ulcer and major disability. This syndrome is more likely to develop with more severe degree of deep vein thrombosis. Pharmacomechanical thrombolysis for treatment go deep vein thrombosis is act to rapidly remove thrombus and hence reduce the severity of deep vein thrombosis. Hence, it may reduce the incidence of postthrombotic syndrome. This study describes a single-center experience in the treatment of deep vein thrombosis to see whether pharmacomechanical thrombolysis for proximal iliofemoral deep vein thrombosis would reduce the incidence of postthrombotic syndrome compared to the historical data for patient receiving anticoagulation only. Methods: A retrospective data collection for patients underwent pharmacomechanical thrombolysis were performed for iliofemoral Deep vein thrombosis in a single center (Alrayyan Hospital, Riyadh). A demographic-, clinical-, procedural-, and postprocedural-related data were collected including 24-month incidence of postthrombotic syndrome were collected. A comparison of postthrombotic syndrome incidence for iliofemoral deep vein thrombosis using pharmacomechanical thrombolysis with liberal use of stenting compared to anticoagulation alone using historical data. Results: Fourteen patients underwent pharmacomechanical thrombolysis to treat iliofemoral deep vein thrombosis between May 2015 and July 2017. The average age is 39 years of age (22–67 years of age), eleven females and three males. Eight out of fourteen cases were identified to be May-Thurner syndrome either by computed tomography or intravascular ultrasound. Two patients were postpartum deep vein thrombosis. Eleven patients had left-sided iliofemoral deep vein thrombosis. All patient underwent 24 h thrombolysis, but two patients required 48 h thrombolysis as per a protocol for none of the patients developed major bleeding. Eleven patients underwent stenting, and ten patients had retrievable inferior vena cava filter, who are all retrieved within 1 month, except one retrieved after 6 months. Twelve patients were adherent to compression stocking with instructions of 8–12 h daily use for 2 years' duration. Among the 14-patient cohort, only one patient (7%) developed postthrombotic syndrome. The historical and contemporary incidence of postthrombotic Syndrome is 50% with the use of anticoagulation for all comers of deep vein thrombosis. Conclusion: This is a single-center experience of treatment of Iliofemoral deep thrombosis with liberal use of venous stenting. This study reports the incidence of postthrombotic syndrome is reduced markedly to 7% as compared to the use of anticoagulation alone in a contemprory data is 50%.



Publication History

Article published online:
11 May 2021

© 2018. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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